Medicare and Moving: What You Need to Know
What to do When Moving to Another State with Medicare?
KEY POINTS
- Original Medicare and Medigap plans will move with you from one state to another.
- If you move with an Advantage plan or Part D plan, you will have a 2-month window to enroll in a different plan.
- When you move with a Medigap plan, your premium can change, and underwriting may be required if you want to change carriers.
When moving , many people create a checklist to stay organized in the process. As a a senior on medicare, one thing you will need to add to your list is “Updating Medicare.”
This is not as simple as it may seem, as not all Medicare parts are transferable between states. For example, Medicare Advantage (Part C) and Medicare Part D drug plans are offered based on the residential area you live in.
When you move out of that area, you need to notify your Medicare Plan providers. It’s important to inform the right parties within the allotted timeframe, so you don’t accidentally end up with a lapse in coverage.
If you’re enrolled in a Medicare supplement, the rules are slightly different, but your policy may change in price depending on where you move to.
Moving States when enrolled in a Medicare Advantage.
If you’re enrolled in a Medicare Advantage plan or Medicare Part D (prescription drug plan) and are moving outside your plan’s service area, you will need to enroll in a plan that is within your new service area. This is true whether you move to a new address in your state or to a new state.
Medicare Advantage Plans have networks that operate in select counties where you live, so if you move from one state to another, you will almost always need to change your plan.
When you move, you can enroll in a new Medicare Advantage plan in your new zip code or choose to return to Original Medicare and apply for a Medigap policy. Moving out of your Medicare Advantage plan’s service area opens up a Guaranteed Issue window for Medigap plans, meaning you could apply for a Medigap plan without having to answer health questions. The Plan G not the Plan N is the only supplement you can enroll in if you were on under 65 on 1/1/2020. If you were 65 or over on 1/1/2020 you can enroll in the Plan F with no health question asked
Moving with a Standalone Prescription Drug Plan (PDP)
Most people with Original Medicare and a Medigap plan also have a standalone Part D drug plan. When moving to another state, getting a new drug plan is inevitable because drug plans are state-specific. Even if you choose the same insurance company for your drug plan in your new state, your plan number will be different, so you have to apply for the new plan.
Additionally, Medicare keeps track of your Part D spending. You will enter the new Part D plan in the same stage you had left the old plan. For example, if you are in the coverage gap in the old plan, then you will enter your new plan in the coverage gap.
If you decide that you don’t want to get a new PDP when you move, just be aware that there will likely be a late penalty when you re-enroll in a drug plan.
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Using the Medicare Special Enrollment Period (SEP)
You can use the Medicare special enrollment period to make make changes to your coverage if:
- You are moving out of your Medicare Advantage plan’s service area
- You are moving to a new location that’s still in your Medicare plan’s service area, but there are new plan options available in your new area
You can use your Special Election Period (SEP) to switch to a different Medicare Advantage plan or Part D coverage. You must contact your Medicare Advantage plan to disenroll.
If you notify your Advantage plan before you move , your SEP starts the month before you move and continues for two more months after you move. If you let your Advantage plan know after you’ve moved , your SEP starts the month you tell your plan and continues for another two months.
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Guaranteed-issue rights and Medigap plans
In most cases, you won’t be able to switch your Medigap policy outside your 6-month Medigap Open Enrollment Period without medical underwriting except in specific situationsYou are moving to a new location that’s still in your Medicare plan’s service area, but there are new plan options available in your new area
Guaranteed-issue rights are granted if you move outside of your Medicare Advantage plan’s service area. This is important because before you move, your SEP starts the month before you move and continues for two more months after you move. If you let your Advantage plan know after you’ve moved , your SEP starts the month you tell your plan and continues for another two months.
Medicare Supplement Insurance and Moving
Nearly 50% of Medicare beneficiaries are NOT enrolled in a Medicare Advantage plan. Instead, they have Original Medicare consisting of Part A and Part B coverage. Some will also have a Medigap plan that works alongside their Medicare Part A and B benefits.
Original Medicare is a federal benefit. Your benefits under Parts A and B do not change when you move from one state to another with Medicare. You can also take your Medigap plan with you to another state.
A Medigap policy, also called Medicare supplement insurance, is private health insurance that supplements Original Medicare. This means it helps pay for some of the “gaps” that Original Medicare doesn’t cover, such as copayments, coinsurance and deductibles. Medigap policies only help pay if you are enrolled in Original Medicare. You don’t need (and can’t buy) a Medigap policy if you’re in a Medicare Advantage health plan.
But you can purchase a Medigap plan with guaranteed-issue rights if you were enrolled in a Medicare Advantage plan and are moving out of your Medicare Advantage plan’s service area. However, you must first switch back to Original Medicare. After you return to Original Medicare, you can enroll with guaranteed-issue rights in certain Medigap insurance plans offered by any insurance company in your state.
If you choose to switch to a different Medigap plan offered in your new location keep in mind that if you don’t have guaranteed-issue rights, you will probably have to pay a higher premium for that coverage or could be rejected if you have pre-existing health problems .
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Notify the Social Security Administration (SSA) if you move
If you’re moving, you should contact Social Security to update the mailing address that Medicare has on file for you. Medicare works with SSA to maintain your records and you don’t want to miss any important notifications.
Here is how you can notify the SSA:
- Online: Use the Social Security website, ssa.gov , to update your information online. If you have a My Social Security account , you can log into your account to update your address.
- By Phone: Call Social Security at 1-800-772-1213 (TTY users, dial 1-800-325-0778), Monday through Friday, from 8am to 7pm in all time zones.
- If you choose to apply for a new plan, know that a few states have unique Medigap plans and rules that aren’t like other states. Moving Medicare from one state to another in Wisconsin, Massachusetts, or Minnesota means that the structure of your benefits may also change.